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OMM Final Exam > M1T1 OMM Midterm > Flashcards

M1T1 OMM Midterm Flashcards

1
Q

Before engaging in palpation, what should you ask/tell the patient?

A

Ask for permission to palpate. After receiving permission, inform the patient what you are going to do

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2
Q

What are characteristics of deep fascia?

A

Partitions muscles into groups
Densely packed (thin and strong)
Most extensive
External investing and deep investing layers

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3
Q

What vertebral level does the umbilicus approximate?

A

T10

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4
Q

What vertebral level does the sternal angle approximate?

A

T4

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5
Q

Fascia is composed of ________ and ________ fibers and a ground substance composed of ________ and ________.

A

Collagen, elastin, thin gel, mineral salts (in bone)

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6
Q

________ occurs when there is an increased frequency of action potentials (which can lead to tetany or maximal sustained contraction).

A

Frequency summation

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7
Q

80% of healthy individuals have an alternating Zink fascial pattern. What is this pattern starting from the head?

A

OA: ease leftCT: ease rightTL: ease leftLS: ease right

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8
Q

Which model was J. Gordon Zink a champion of?

A

Respiratory-circulatory model

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9
Q

A ________ is a functional limit within the anatomical range that diminishes the normal physiological range.

A

Restrictive barrier

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10
Q

What are the characteristics of an acute somatic dysfunction?

A

Pain: acute, severe, sharp
Vasculature: vasodilation and inflammation
Skin: warm, moist, red/inflamed
Tissues: edema, boggy
Musculature: increase in local tone (hypertonic) leading to contraction, spasm, or poor quality of motion
Viscera: minimal somatovisceral effects

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11
Q

What is the definition of touch?

A

Physical contact involved in palpation

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12
Q

What are the spaces between muscle fibers filled with and what does it contain?

A

Sarcoplasm. K, Mg, PO4, enzymes, lots of mitochondria, sarcoplasmic reticulum

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13
Q

Define elasticity and plasticity.

A

Elasticity: ability to resume original shape after deformationPlasticity: ability to retain shape after deformation

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14
Q

What happens when a muscle is at rest?

A

The muscle receives impulses from the spinal cord so a certain amount of tautness remains in the muscle at all times

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15
Q

How far do muscle fibers span and how many neurons innervate one fiber?

A

The entire length of the muscle and only 1 neuron per fiber

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16
Q

Small motor units are recruited initially followed by larger motor units (if necessary) is a process known as ________.

A

Multiple fiber summation

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17
Q

What adds new sarcomeres to the ends of muscles?

A

Stretching

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18
Q

What is the term for “bow-legged”?

A

Genu varus

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19
Q

Myofascial release, myofascial unwinding, and ligamentous articular strain are all ________ techniques.

A

Indirect

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20
Q

If loss of signal from neurons causes atrophy in muscle, what will eventually happen over time if there is no recovery?

A

Replacement by fibrous and fatty tissue which contracts over time

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21
Q

A force generated by skeletal muscle that is spread throughout the connective tissue (fascia) is called a ________.

A

Epimuscular pathway

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22
Q

Unused muscle is degraded or muscle protein degraded faster than it is replaced are two ways that ________ can occur.

A

Muscular atrophy

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23
Q

When can you treat a somatic dysfunction?

A

Indication for OMMIndependent of other diagnosesDocumentableTrack improvement over timeBillable

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24
Q

Soft-tissue and myofascial release are both ________ techniques.

A

Direct

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25
Q

The capability of a solid to continually yield under stress with a measurable rate of deformation is known as ________ (as a property of fascia).

A

Viscosity

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26
Q

What are characteristics of superficial fascia?

A

Attached to skin
Dense at the scalp, back of neck, and palms of hands and feet
Loose everywhere else
Holds the vast majority of interstitial fluid

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27
Q

What is a cybernetic loop?

A

An unconscious reaction by the patient followed by a similar unconscious reaction by the physician

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28
Q

An ________ is the limit of passive motion (bony endpoint).

A

Anatomical barrier

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29
Q

A ________ is the limit of active motion and is ________ of being altered.

A

Physiological barrier, capable

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30
Q

Where was fascia first officially defined?

A

First International Fascia Research Congress

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31
Q

Lots of mitochondria, smaller, smaller nerves, extensive blood supply, and large supplies of myoglobin (red) are all characteristics of ________ type muscle fibers.

A

Slow

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32
Q

What is the term for “pigeon breast”?

A

Pectus carinatum

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33
Q

What is a spinal dysraphism?

A

An incomplete fusion or malformation of bone and neural structures of the spine region

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34
Q

Continued deformation of a visco-elastic material under constant load over time is also known as ________.

A

Creep

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35
Q

Fewer mitochondria, larger, extensive sarcoplasmic reticulum, minimal blood supply, less myoglobin (white), and glycolytic enzymes present are all characteristics of ________ type muscle fibers.

A

Fast

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36
Q

Detection of a mechanical problem, locating a problem, and measuring improvement are all reasons for why we perform ________. It is the most objective assessment tool for categorizing somatic dysfunction.

A

Motion testing

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37
Q

How much energy from nutrients gets used to make ATP and how much of nutrients can be converted to Work, under optimal conditions?

A

50% and 25%

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38
Q

A ________ is all muscle fibers that are innervated by a single neuron.

A

Motor unit

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39
Q

How can hypertrophy be described in muscle?

A

Existing muscle fibers gain more actin and myosin. New muscle fibers are not created

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40
Q

When is phosphocreatine used and for how long?

A

At the beginning of contraction (maximal) for approximately 5-8 seconds

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41
Q

What are I bands and how do they appear under a light microscope?

A

Regions composed entirely of actin and appear white

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42
Q

Why was touch “lost” in patient-physician interactions during the dark ages?

A

Physicians avoided touching patients due to the plague

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43
Q

What is the “ideal structure” of the human body?

A

Symmetry in all three planes

44
Q

The normal thoracic spine ROM degrees are ________ (T1-T4), ________ (T5-T8), and ________ (T9-T12) for lateral flexion and ________ (T9-T12) for rotation.

A

5-25, 10-30, 20-40, 30-45

45
Q

What does troponin inhibit and what prevents troponin from doing so?

A

Cross-bridging and Ca++ (troponin has a high affinity for Ca++)

46
Q

What are the two types of contractions and their respective subdivisions?

A

Isometric: contraction where muscle does not change length
Isotonic:
- eccentric: contraction where muscle gets longer
- concentric: contraction where muscle gets shorter

47
Q

Name the different types of mechanoreceptors.

A

Pacinian corpuscles, Meissner’s corpuscles, Ruffini corpuscles, Merkel’s discs

48
Q

How much of the ECM is water?

A

90%

49
Q

For multistage exams for somatic dysfunction, what should you do and in what order?

A

Screening - general impression (whole body)Scanning - scan regions identified by screening (ex. thoracic region)Local examination - specific tissue characteristics

50
Q

Stress applied to a body is proportional to the strain produced as long as the limit of elasticity is not exceeded. This is known as ________ law.

A

Hooke’s

51
Q

Which vertebral level does the spine of the scapula approximate?

A

T3 (spinous process and transverse process)

52
Q

Where are the transition zones?

A

OccipitoatlantalCervicothoracicThoracolumbarLumbosacral

53
Q

What metabolic pathway supplies 95% of sustained contraction?

A

Oxidative phosphorylation

54
Q

________ can be defined as all the collagenous-based soft-tissues in the body, including the cells that create and maintain that network of extra-cellular matrix.

A

Fascia

55
Q

When do “cross-overs” occur? Where does this typically occur?

A

Whenever the postural line crosses the gravitational line. At transition zones

56
Q

The perceived quality of motion as an anatomical/physiologic restrictive barrier is approached is known as ________.

A

End-feel

57
Q

What is the smallest size the fingers are able to discriminate?

A

1-2mm

58
Q

________ involves the way a system is held together by its connecting elements to create/maintain balance between stability and strength.

A

Tensegrity

59
Q

Somatic dysfunction is named for it’s ________.

A

Ease

60
Q

There are ________ contraindications to myofascial release techniques.

A

No

61
Q

When do we stop making elastin?

A

Around 12-13

62
Q

How was fascia described in the past?

A

Something that separated one organ from another, something that was dissected through, or something that was discarded,

63
Q

What is the term for “knock-kneed”?

A

Genu valgus

64
Q

What is hyperextension of the knee called?

A

Genu recurvatum

65
Q

What are the objective diagnostic findings of somatic dysfunction?

A

TART:Tissue texture changeAsymmetryRestricted Range of MotionTenderness

66
Q

What are the causes of Cushing’s Disease/Syndrome? What are some signs and symptoms?

A

Excessive amounts of cortisol for a long period of time (either due to corticosteroid medication or endogenous overproduction)Hypertension, diabetes, osteoporosis, moon face, buffalo hump, depression, mood swings

67
Q

________ motor muscles have motor units consisting of a few muscle fibers whereas ________ motor muscles have motor units consisting of many muscle fibers.

A

Fine, gross

68
Q

How is fascia related to each of the models of osteopathic care?

A

Structural: plays a role in Dx and TxRespiratory-Circulatory: may act as a barrier to circulation, respiration pulls all fascia Neurologic: reflects physiological stateBehavioral: myofascial reflection of inner emotion Metabolic: directs forces, metabolic activity takes place in fascia

69
Q

Define somatic dysfunction.

A

Impaired or altered function of related components of the somatic system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements

70
Q

A ________ is a form of a restrictive barrier in which permanent restriction of joint motion is associated with a pathological change in tissues.

A

Pathological barrier

71
Q

Medial and lateral winging of the scapula are caused by damage to what muscles/nerves?

A

Medial winging: serratus anterior - long thoracic nerveLateral winging: rhomboids and trapezius - dorsal scapular and spinal accessory nerves

72
Q

What links Z disks with myosin filaments?

A

Titin

73
Q

What is believed to attach tropomyosin to actin?

A

Troponin

74
Q

What vertebral level does the iliac crest approximate?

A

L4 (spinous process) - malesL5 (spinous process) - females

75
Q

What vertebral level does the nipple line approximate?

A

T4

76
Q

What is the definition of palpation?

A

Diagnostic and therapeutic “touch” as combined with OMT

77
Q

What are A bands and how do they appear under a light microscope?

A

Composed of myosin filaments, either alone or overlapping with I bands. They appear dark

78
Q

What are Z disks and what is the region between 2 Z disks called?

A

The anchoring site of actin. Sarcomere

79
Q

In relation to the interconnectedness of fascia, what happens when your inhale/exhale?

A

Inhale: spinal curves straighten, extremities externally rotateExhale: spinal curves are exaggerated, extremities internally rotate

80
Q

________ is a sense of resistance to light traction applied to the skin.

A

Skin drag

81
Q

Where do mechanoreceptors orient themselves?

A

Along fascial architecture

82
Q

How does each head of myosin act when “walking” across the actin?

A

Independently

83
Q

What vertebral level does the inferior angle of the scapula approximate?

A

T7 (spinous process), T8 (transverse process)

84
Q

What are the 3 types of motion used in OMM?

A

Active, passive, inherent

Sub-classification of active/passive: regional, intersegmental

85
Q

What are the five fascial functions?

A

PackagingPassagewaysProtectionPowerProprioception/Nociception

86
Q

What is special about the hip drop test?

A

It is a passive test that utilizes active motion

87
Q

What does fascia need to function properly?

A

Water

88
Q

What is the term for foot pronation?

A

Pes planus

89
Q

What does inelastic fascia assist with and where is it found?

A

Increased pressure within a compartment to aid in blood and lymph circulation. Anterior compartment of the crus

90
Q

What are the characteristics of a chronic somatic dysfunction?

A

Pain: dull, achy, itching, crawling, gnawing, burning
Vasculature: vasoconstriction due to hypersympathetic tone
Skin: cool, pale due to chronic increase sympathetic vascular tone
Tissues: chronic congestion, stringy, ropy, fibrotic, contracture, thickened
Musculature: hypotonic, mushy, limited range of motion due to contracture
Viscera: somatovisceral effects common

91
Q

What is the term for “funnel chest”?

A

Pectus excavatum

92
Q

The normal cervical spine ROM degrees are ________ for flexion/extension, ________ for lateral flexion, and ________ for rotation.

A

45-90, 30-45, 70-90

93
Q

What is the term for foot supination?

A

Pes cavus

94
Q

With active and passive motion testing, in what order should you test the patient?

A

Active and then passive

95
Q

How many myofibrils is each muscle fiber composed of?

A

Hundreds to thousands (approximately 1500 myosin filaments and 3000 actin filaments)

96
Q

A relative palpable freedom of motion of an articulation or tissue is known as ________.

A

Ease

97
Q

What does TART stand for?

A

Tissue texture changes, asymmetry, restricted range of motion, tenderness

98
Q

What are the three classes of molecules contained within the ECM?

A

Structural proteins (collagen and elastins)ProteoglycansAdhesive glycoproteins (fibronectins and laminins)

99
Q

In what order should you proceed with an examination regarding OMT?

A

Static structural examRegional range of motionLayer-by-layer palpationInter-segmental motion testing

100
Q

What are the four types of mechanoreceptors?

A

Meissner’s corpuscle, Pacinian corpuscle, Ruffini corpuscle, Merkel disks

101
Q

The normal lumbar spine ROM degrees are _________ for flexion, ________ for extension, and ________ for lateral flexion.

A

70-90, 30-45, 20-35

102
Q

A ________ is a normal physiological mechanism via an action potential and Ca++ release, whereas a ________ is tightening due to collagenous bands laid down by fibroblasts.

A

Contraction, contracture

103
Q

The range between the physiological barrier and anatomical barrier is known as an ________. This is where ________ occurs before tissue disruption.

A

Elastic barrier, passive ligamentous stretching

104
Q

What order should be followed for layer-by-layer palpation?

A 
Observation
Temperature
Skin (scarcely touching)
Fascia (no blanching of fingernails)
Muscle (some blanching)
Bone, tendon, ligament (complete blanching)
Erythema friction rub
105
Q

What anaerobic method of ATP production can be used to supply muscle? How long does it last?

A

Glycolysis. Approximately 1 min

106
Q

What is required for Ca++ to be pumped back into the sarcoplasmic reticulum?

A

ATP

OMM Final Exam (12 decks)

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